Why the Opioid Crisis Is So Personal to Trump

On Thursday, President Donald Trump declared the abuse of opioid painkillers to be a public health emergency in the United States.

Thursday’s announcement is Trump’s first official step toward fulfilling a major campaign pledge, and gives the federal government additional powers to combat heroin and painkillers abuse.

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One such power will be the use of “telemedicine,” the remote prescribing of medicine commonly used for substance abuse or mental health treatment.

Trump told a packed East Room, full of federal officials and families who have lost a loved one to heroin or painkillers, that he will direct all federal agencies to use every emergency provision in their arsenal.

For Trump, the battle is personal, although he never struggled because he learned the dangers of addiction by observing a family member.

“I learned myself, I had a brother Fred, great guy, best-looking guy, best personality, much better than mine, but he had a problem,” Trump told the crowd. “He had a problem with alcohol. And he would tell me, ‘Don’t drink. Don’t drink.’ And to this day, I’ve never had a drink. And I have no longing for it. I have no interest in it.”

Fred Trump Jr. died in 1981 at age 43, a victim of addiction.

Trump promised specific action, including a crackdown on imports of Chinese-made fentanyl, which is 50 times more potent than street heroin. The White House said the rise in overdose deaths is largely due to the supply of illicitly made fentanyl, a highly potent synthetic opioid, and fentanyl-like drugs.

Trump said he would discuss the issue with Chinese President Xi Jinping when they meet in China next month.

Drug overdoses are the leading cause of unintended death in the United States. What have been driving the numbers lately are the more than 1 million Americans using heroin, and 11 million Americans using synthetic opioids, Trump said.

The drug saga has been ongoing for decades in the United States, but a rise in painkiller and heroin deaths has been steady for about 20 years, eclipsing the problems of addiction to lesser drugs such as cocaine and methamphetamine. Compounding the opioid problem is the relatively new cheapness of heroin, an alternative if users cannot get prescriptions or black-market supplies for the potent opioid painkillers.

The deaths have struck America differently than past problems, such as the period in the 1980s and 1990s when the federal government declared a “War on Drugs.” Back then, it was an array of drugs targeted. Some of the drugs, like cocaine, were dangerous if abused, but less addictive than opioids.

Opioids have other hazards beyond addiction. In Scott County, Indiana, in 2015, public authorities, including then-Gov. Mike Pence, allowed the health department to offer free needles after 190 cases of HIV broke out. It was one of the worst HIV outbreaks that officials could recall in so small a community, caused by the use of shared needles to inject heroin and methamphetamine.

Public officials throughout the United States have also been distributing Narcan, which can be used to immediately treat opioid overdose.

But somehow, the efforts have fallen short. About 64,000 Americans died of overdoses in 2016, according to the White House.

The stories moved the White House. As Melania Trump introduced her husband in the East Room, a woman stood behind the first couple, holding a picture of a loved one, presumably lost to the opioid scourge.

But the scourge is tricky to treat. Legal prescription painkillers were sought four times as much by 2010 as they were in 1999.

Trump blamed some of the opioid problem on illegal supply from south of the border, and emphasized the need to build the wall on the southern border with Mexico.

“An astonishing 90 percent of the heroin in America comes from south of the border, where we will be building a wall, which will greatly help in this problem,” said Trump.

Some of the painkiller problem has also been caused by war and an aging population, with senior citizens and scarred veterans suffering from real physical pain.

The White House said the Department of Defense, Department of Veterans Affairs, National Institutes of Health, and Department of Health and Human Services are now collaborating on a six-year, $81 million joint research partnership focusing on nondrug approaches to managing pain to address this new need.